Should I, and how do I, say "no" to my unstable friend about visiting me?October 30, 2010 1:37 PMSubscribe

A troubled friend wants to visit with me for a couple of weeks, and is obviously very serious about it. I don't really have the time or energy to take him in, but I know his reaction won't be pretty if I say "no," and I don't know if I can handle worrying about him. (Long.)

Hi. I'm a male college student in my early 20's. I have a seriously mentally ill friend with whom I have a pretty complicated relationship. He has borderline Asperger's, is intermittently severely depressed and often displays borderline-like behavior, where he will do or threaten self-destructive things for attention or to get what he wants (consciously or not). We live on opposite coasts, but we've had extended in-person visits a few times in the past, events which he puts a great deal of weight on, because he sees it as a rare opportunity to hang out with someone like-minded and supportive and discharge the stress of his troubled family life, etc. He is about to enter a new stage of his career, which will be quite time-consuming, but over winter break he'll have an opportunity to fly out here and hang out for a couple of weeks, which he thinks may be the last opportunity for years. Of course, he really, really wants to come.

The problem is, I don't really want him to. I'm in the middle of a bunch of stressful changes in my own family life and a relatively tough school year, and as I get older I find it increasingly embarrassing to be seen around him by my friends and family. The line I'm currently giving him is, "I'm not sure yet, but I can't see anything in the way at the moment."

But he's begun to give me the borderline-y drama treatment: he says if he couldn't come he'd be thrown back into depression, likely be suicidal, etc. This is not an empty threat: he has had countless months-long mental health crises, consisting of severe depression, mood swings, dissociation, almost delusional thinking, etc. He is relatively stable now (on a couple of antidepressants and a low dose of a benzodiazepine, largely thanks to my prodding), and his life is actually kind of coming together on several levels. But it's not hard to believe that he will be thrown into a pretty bad state again if he gets told he can't come. And if he does have another episode, I will definitely be the main person to deal with it: I'm the one of all his friends who cares the most about his well-being, and the only other one who was even in the ballpark just moved away, so he'll be less involved now. All the others are barely trying. His family is just as flaky as him, and whenever they're clued in about his problems, they overreact, try to dominate him and impose their own plans for his life, and basically cause more trouble than good; the only times they seem to be a positive influence is basically direct intervention in a suicide threat. He sees a psychiatrist for his medication, but he's not interested in a therapist, and it's very hard to get him to engage the mental health field on any level other than drugs (something which I want to push him to change, but I can't necessarily make anything happen in the short term). So every time he has a crisis, it's almost entirely me that deals with it.

So I'm between a rock and a hard place. I don't want to do the visit, but I can't handle literally months of having to talk to him for a couple hours a day most days just to get him to the point of promising he'll live another day--which has happened several times in the past.

Obviously, there are some real questions about whether this is a healthy relationship for me to be in at all. You don't have to be Sherlock Holmes to deduce that there is lots of fucked up codependency in the picture here, and this has all evolved in a complicated way over almost a decade, that would be hard to summarize here. But I've gotten past the point of this being pure codependent worrying about his welfare--I understand that I should be able to live my life too, even if it hurts him badly. Instead, I mainly worry that he'll make another serious or even successful suicide attempt and that will be on my conscience. I have pretty serious issues with general anxiety, so if I tell him he can't come and he freaks out, I can't just say "fuck it" and take a somewhat hands-off approach. Even if, statistically, the chance of a successful suicide attempt is relatively small, I'm the main outside variable that affects his survival, and if he gets thrown into another extended suicidal crisis, the worrying would hurt my grades for the rest of the semester--especially if I try to be hands-off about it.

I understand intellectually that I should be allowed to live my own life, but considering I'll be moving into finals in just a few weeks, and the worrying would certainly destroy my focus, I can't help feeling like it may be easier just to let him come, bite the bullet on spending a bunch of time and energy when I can't really afford it, and deal with the larger question of how can I approach this relationship in a more healthy way later.

I plan to start seeing a therapist soon, about him and many other issues, but I only have a couple weeks before he'll start really pressuring me about whether he should buy a plane ticket or not. Obviously neither option is going to be pretty, but I've reached an impasse in my thought about this, so I figured I'd throw it out there to a smart, unbiased group of people and see if you had any thoughts.

>We live on opposite coasts
>I'll be moving into finals in just a few weeks
>I'm in the middle of a bunch of stressful changes in my own family life and a relatively tough school year
>he has had countless months-long mental health crises, consisting of severe depression, mood swings, dissociation, almost delusional thinking, etc

"Listen, this is not a good time for you to visit. School is tough, finals are coming up soon, and I'm dealing with a bunch of difficult things right now too. And as your friend, honestly I think the best thing for you to do right now, is to stay at home and focus on dealing with your issues. But tell you what, maybe after finals I'll fly out to visit you for a week or so and see how you're doing. OK?"posted by thermonuclear.jive.turkey at 1:45 PM on October 30, 2010 [2 favorites]

You say, "I'm sorry, it's not going to work." Because it's not. Not for you, and while you're a very kind person, his problems are not yours.

"I'm sorry, it's not going to work." Email if necessary.posted by dzaz at 1:46 PM on October 30, 2010 [9 favorites]

Maybe invite him out for a long weekend but explain that a longer visit isn't possible at this time.posted by pseudonick at 2:02 PM on October 30, 2010 [2 favorites]

It sounds like you know that this is an unhealthy relationship. Yes, you should seek therapy. Refusing the visit would also be a healthy thing to do, but it sounds like you feel unable to do that... in which case, all I can offer is sympathy. My ex-wife used the same sorts of tactics for years, until my ability to extend her any compassion finally wore out. I cared and cared and cared and then something snapped and I couldn't care anymore. One day she tried to kill herself in front of me, to take my attention by force when I was no longer willing to give it freely. She survived. The marriage didn't.

I hope you don't let it get so far with your friend, because for me it had some unpleasant consequences for my relationships with other people that lasted for years afterward. Seek help sooner rather than later.posted by jon1270 at 2:34 PM on October 30, 2010 [1 favorite]

he says if he couldn't come he'd be thrown back into depression, likely be suicidal, etc.

This isn't borderline drama, it's seriously manipulative. Tell him it's not going to work, as dzaz suggests--be serious, believe that your reasons are legit, but don't give him ammunition to use against you ("Oh, so your finals are more important than me?"). Firm and concise is the way to go. And when he starts in with the manipulative stuff about becoming suicidal, tell him that you're very worried about him and that if his depression is severe enough that a change in travel plans throws him into despair, he needs different meds, more/different talk therapy, and possibly inpatient treatment. You can be sincerely concerned about him while holding your ground.

Also, something to keep in mind is that a person who gets his way by threatening suicide isn't necessarily going to kill himself if you tell him no: he may simply move on to another person he can more successfully manipulate. I don't mean he's faking his mental illness or that he doesn't deserve your concern or that he's never truly been suicidal, I just mean that if this is how he relates to people he's more likely to find another person to relate to in this way than he is likely to make good on his threats.posted by Meg_Murry at 2:35 PM on October 30, 2010 [1 favorite]

Maybe you can suggest meeting somewhere in the middle in the spring to hang out? I don't know where you are, but assuming you're on opposite US coasts, maybe a 4-day weekend in Chicago or Austin or something to get together and see something new. This way, you're not totally blowing him off, but you're also not accepting the burden of a houseguest for a couple weeks. (I love having people over and there are a few friends that I would gladly host for whatever amount of time, but for someone to invite themselves and assume it's ok for a couple weeks is ridiculous.)

I can't handle literally months of having to talk to him for a couple hours a day most days just to get him to the point of promising he'll live another day--which has happened several times in the past.

He is manipulating you, and he loves the attention. Be less available (you said it yourself, you know that you need your own life here), he will manipulate you less. I agree with ColdChef - you have been a great friend to him, but what has he done for you? I get that it's nice to feel important to someone (I've sort of been in your shoes), but a friendship that is focused on one person is not a friendship.

...deal with the larger question of how can I approach this relationship in a more healthy way later.

There's always a reason NOT to do something.Sure, you can suck it up and deal with it, thinking you'll address the relationship later. Then "later" comes, and there will be some other reason to put it off. No time like the present, my friend.posted by AlisonM at 2:36 PM on October 30, 2010 [1 favorite]

This story (PDF) was linked by someone on AskMe a while back. I think it's a bit clunky, but the message is that suicide is an active choice someone makes, by themselves, and their attempt to pin responsibility on you doesn't actually make you responsible. Your friend's refusal to see a therapist is also his choice, and does not obligate you to stand in as one.posted by Dixon Ticonderoga at 3:09 PM on October 30, 2010 [10 favorites]

You are not a "support system" - you are a human being. You have got to take care of yourself. It's awesome to help people out, but do it from a position of strength, when you have excess to give.

For another person to demand that they be able to throw your life off kilter so that they can use you as some sort of crutch is really not acceptable. One of the biggest problems of coping with mentally ill people seems to be being able to cut through their self-absorption. There has to be a point at which you can draw the line and say "as much as I care about you and want you to be well, you are not the only person being affected by this, and I cannot let this derail my life."

As far as the suicide crap, if he feels duty-bound to follow through, then seriously, he was far gone enough that you alone were not enough to save him, but you need to go ahead and take the gamble that if you do not answer your phone for a few days, he'll live through it. The only way to find out is to go ahead and leap. Tell him not to come, and if the phone calls start up, don't take them. A ringing phone requires no response. Caller ID is awesome. Use it.

I was married to a woman who developed a lot of the symptoms of BPD -- abusive and controlling, followed by weepy-apologetic, followed by insane demands with ultimatums, followed by ridiculously large gifts out of the blue, just so she could hold them over my head when she wanted something from me afterwards ("I do so much for you, and this is the thanks get?") -- this carried on in fits and starts for a number of years post-divorce (I tried to hold on and be "reasonable" because we had a child in a joint-custody scenario) but one day, I pretty much just said "Stop calling me." She still calls every once in a while, but the every day-clingy part is finally gone for the last year or so, and hey, she survived, and I'm pretty relieved to have finally put my foot down and gotten the burden off of my back.

A lot of people are giving simple advice like, "just break it to him in this or that curteous way about why you don't want him to come." But the point is, I can't get away with that without enduring monstrous amounts of anxiety during his likely ensuing breakdown. I know how I would tell him, I just don't know how to deal with the aftermath, or if turning him down would even be worth all of the fallout. It may actually be easier for me to let him come, but it does seem unfair to be guilted into this, and maybe if I turned him down I could still find a way to steel myself to the drama and come out of it better off on the whole--though it's hard to envision now.

And to Meg_Murry, when I said "borderline-y drama," I didn't mean that it was a borderline case (horrors no!), I mean it's similar to someone with a Borderline Personality Disorder, which he may well have. I have no doubt that he's very manipulative, though as is often the case with people with this type of personality, it's not entirely clear to me to what degree it's conscious. From the wiki page: Individuals with BPD are often described, including by some mental health professionals (and in the DSM-IV), as deliberately manipulative or difficult, but analysis and findings generally trace behaviors to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills.

Also, to be clear, his visit doesn't conflict with my finals (it would be over winter break), but the worrying I would have to do if I broke it to him now that he couldn't come certainly would. And don't think that's something minor: I'm a pretty anxious person to start with, and when he's having an episode, it makes it almost impossible for me to get work done until 2AM the night before, which leads to a downward spiral of sleep deprivation, poor performance, even worse anxiety about not getting things done, more sleep deprivation, etc. It's not like he's the only thing that's ever caused me to get that way, but boy, he's up there. Figuring out how to reduce his ability to monopolize my time and emotional life has become a top priority for me, but it's not something I'm going to pull off in the next week or two, and again, this is likely to be the last such ultimatum for some time.

Thanks everybody for all of your thoughts so far, and I'm sure I'll follow up once or twice more.

I second the long weekend suggestion. Make other plans for the rest of your break, tell him you can have him visit for X amount of days but that's all. Even 5 days if you can stand it. Why does it have to be several weeks? That is just rude to tell someone you are coming for that length of time.posted by mermayd at 3:33 PM on October 30, 2010

I'm a pretty anxious person to start with, and when he's having an episode, it makes it almost impossible for me to get work done until 2AM the night before, which leads to a downward spiral of sleep deprivation, poor performance, even worse anxiety about not getting things done, more sleep deprivation, etc.

Please go see a psychiatrist about this right away, friend or no friend. There are good anti-anxiety meds that will help you with this right now. I was pretty much a gibbering sleep-deprived mess three years ago as I tried to salvage a slowly sinking small business. I went to a good doctor who put me on a small dose of Klonapin -- enough so that I could basically stop shaking, sleep at night, and get my feet out of the bed and on to the floor. That put me in a much better position to work on the issues that had been casing the crazy anxiety in the first place (yes, the wacky ex-wife was a big contributor) and get my house in order a bit and refine my life-coping skills. I'm still a periodic insomniac, but now I just get up and read a book, and the panic attacks are long gone.posted by Devils Rancher at 3:41 PM on October 30, 2010 [1 favorite]

About telling him not to come, you said, "I can't get away with that without enduring monstrous amounts of anxiety during his likely ensuing breakdown."

You can if you're clear that his visit isn't going to work and you refuse to be part of his "ensuing breakdown."

I'm sympathetic here, but you're as drawn into the drama of another as much as YOU choose to be.posted by dzaz at 3:44 PM on October 30, 2010 [1 favorite]

Figuring out how to reduce his ability to monopolize my time and emotional life has become a top priority for me

Good, because that's totally unhealthy. Start now by telling him he's not coming.

but it's not something I'm going to pull off in the next week or two, and again, this is likely to be the last such ultimatum for some time

Until the next time - unless you actually steel yourself to do what you know to be right. He'll react in whatever way he'll react. You'll hopefully respect yourself enough to repeat as necessary. The fallout will be whatever the fallout will be and the sooner it starts the sooner it will be over.

Also, consider that you are assuming he's in this new slightly better state than he was and is going to stay that way if he's allowed to come - well, he may not, something else could set him off and you'd be forced to deal with just as much drama.

In terms of how you deal with the drama - you take it as it comes, you restrict communication with this guy if necessary and you get immediate help with your own issues, which may well include some medication to calm yourself down in the short-term until you learn how to react differently.posted by koahiatamadl at 4:24 PM on October 30, 2010

I understand the OP's dilemma, and it's not as simple as just putting off an unwelcome guest. This is a situation in which someone's goodheartedness has placed them in the situation of feeling-- perhaps actually being-- the single caretaker of this person. It's a responsibility he has taken on, one that he felt he couldn't refuse. Of course it's complicated, but the caring and the urge to help are genuine. All this says nothing but good about the OP.

However, it's not something that OP can deal with on his own. I know that's a glib comment that's applied in all sorts of situations, but this is one where it really is the truth. OP, please see a therapist as soon as you possibly can for help with this. The quality of answers here can be very high, but in this case you need more than what you can get online at Ask, and more than advice in turning down a visitor who you don't want to see. Please try and get some advice in person and at length. Only you can judge how serious the suicide threats and possibility of a breakdown are (and they may range anywhere from toxic manipulations and fantasies on your friend's part to serious intentions). Can you talk to his family, as it seems they have been on board for suicide interventions before? What about your family, can they help?

I just don't know how to deal with the aftermath, or if turning him down would even be worth all of the fallout.

You're going to need to learn sometime. I know this sounds like a blow off answer, but every time you give in to his histrionics, you guarantee that it will happen again, and again, and again. It's probably obvious to you that you're not helping yourself - but you are also not helping your friend. It takes 2 people to have an unhealthy relationship, and if you hold up your end, he's sure to hold up his.

I have no experience with Aspergers whatsoever, but deeply sympathize with you due to having suffered issues of a similar nature with 'unstable' friendships in the past. Just a thought: I might be tempted to be completely honest with this person, excusing my availability for the visit for whatever practical obstacles make it difficult for me, but then also telling him (albeit very gently) that i fear his reaction, explaining how distressed this makes me feel in relation to his immediate well being and emotional state. Possibly also telling him that his past reactions have made me somewhat nervous of canceling arrangements with him, etc.

This might be a really bad idea depending on your particular circumstances and his actual behavior, but perhaps it could release tension for you, whilst offering him the honesty card?

Make this about you, also. At the same time as being a good friend concerned about his welfare, you really need to cut yourself some slack. Regardless the dynamics at play here, you are not responsible for his behavior, and your own feelings deserve equal respect and consideration.

I hope you can work something out.posted by noella at 5:15 PM on October 30, 2010

I've been in similar situations with similarly inclined people, some of them family, some of them dear friends who I was concerned would drink themselves to death if I didn't answer the phone or let them visit. It sounds like you already have pretty significant anxiety anyway, so maybe you need to (bear with me):

Pretend to him that you're barely making it
...
so that
...you have room to realize that might not be far from the truth.

That is, you tell him you yourself are having so much trouble doing xyz in your own life that you're not far from a breakdown yourself. You're getting more anxious all the time, and the thought of caring about a guest--even an old friend who (wink, wink) doesn't require any looking after--throws you into paroxysms of fear. You just can't explain it, man. It's terrible. You really want to get help, and it's on your calendar to do so.

This is one of the very practical ways that you can draw a boundary in this type of relationship. And having that boundary established can be a source of light, of air, of courage that lets you seek the help you already realize you need.posted by ImproviseOrDie at 5:27 PM on October 30, 2010 [1 favorite]

From the OP:

Devils Rancher: I forgot to mention that I do have a psychiatrist (mainly for ADHD), who's almost a pure psychopharmacologist (doesn't do therapy), and he's already prescribed me Xanax for occasional use. It's not a fantastic fix. It reduces my anxiety some, but makes me sleepy and foggy, which I can't really afford, since keeping up with my work is a very important part of my general mental health, for the reasons I mentioned before. I haven't tried any of the other benzodiazepines yet, but I'm cautious about whether to expect them to be vastly better than Xanax. I can't take Buspar for medical reasons. So that pretty much leaves SSRIs, and I will probably go on one soon to address my anxiety in general, but they take weeks to kick in, so it wouldn't help for my immediate predicament.

jokeefe: Thank you so much for the very understanding answer. This sums up my predicament. You're awesome. I'm surprised at how many people are seeing this as a simple question of how to go about turning someone down (though I'm grateful for any thoughts). I'm actively working on finding a therapist, but again, I'm not going to advance things much in the--what, two sessions at most?--that I could squeeze in before I have to give my answer about this trip. My own family (which pretty much just consists of my parents) are definitely not appropriate for this, for a variety of reasons; my dad is completely unqualified to reason about issues about human relations (anyone who knows him would agree) and I don't think my mom would have any special insight about this, and she needs the stress even less than me right now, believe me. It is, indeed, incredibly hard to judge the seriousness of his intentions at any given time. In the past, he's made one attempt with OTC painkillers, as well as some "experimentation", e.g., setting up a noose and all that and stepping into it but not kicking the chair. But many of his threats only have the character of vague musings designed to signal the level of pain he's in.

To those who are saying "what's the point of putting off the issue, if he's going to do this again in the future anyway?": I am willing to largely (maybe even totally) disentangle myself from his life and problems in the future, but I'd like to be able to do that gradually and responsibly. If I just let this visit happen, I could avoid another meltdown and immediately begin to tend to figuring out how to put some distance between us (with the help of my therapist), encourage him to take more responsibility for his own life, etc. This isn't just procrastination: it's an attempt to keep the peace so that I can earnestly try to make this situation better.

noella: That's a very thoughtful answer, but I'm not sure if it'd help much. He knows very well (all too well?) that I'd be very worried about his reaction if I told him "no." I'm pretty good about being transparent with him, except perhaps about the level of enjoyment I take in our relationship at this point.

To all of you who are suggesting a shorter visit: It's a thought. Don't know how well it would work, though. Based on what he's said so far, he'd probably claim a short visit wouldn't be worth it. Not that it makes sense that two weeks would be totally necessary but four days would be pointless, but such is the looseness of his thought process.

Bless you for being a good friend. But look at your very last graf: If you suggest a four (or even five) day visit, and he says it's "not worth it," then that's ALL THAT YOU CAN DO MAN, and if he chooses not to come, that's totally on HIM.

Two weeks eats your whole holidays and, fuck that. If it's going to crash the "friendship," and he doesn't care about YOUR stress, then the sooner the better.posted by cyndigo at 5:53 PM on October 30, 2010

OP, if you follow up again, you might want to clarify what you're asking. There's no magical solution. Your relationship with your friend has become extremely unhealthy, and needs to change dramatically or end altogether. You need some help with your personal emotional struggles. You already know these things. I understand that you aren't up to tackling all this at once. That's fine, but start with the low-hanging fruit. Make an appointment with a therapist as soon as office hours permit.

Individuals with BPD are often described, including by some mental health professionals (and in the DSM-IV), as deliberately manipulative or difficult, but analysis and findings generally trace behaviors to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills.

You are way underqualified to be diagnosing your friend, and way too close to him to do so even if you were qualified. Also, it seems significant that you included the last part about inner pain and turmoil, etc. Refusing to let your friend manipulate you and drag you down is not equivalent to passing moral judgment on him. Manipulation is not inherently malicious or even conscious. I'm sure his suffering is quite genuine, but that doesn't make it any less destructive, and you are incapable of helping him escape this cycle so long as you are a participant in the cycle. Don't imagine that you are healing him or saving him from some terrible fate; he is in control of all of that, whether he admits it to himself or not. Your friend is using your fears to perpetuate the relationship as it is. He will never willingly let you disentangle [your]self from his... problems...gradually and responsibly. This will be done against his will, or not at all.posted by jon1270 at 5:57 PM on October 30, 2010 [1 favorite]

Honestly, it sounds like your telling him no will cause you less stress than allowing him to come for the visit. Is this the case? Will you be able to concentrate on your finals knowing what's right around the corner? Maybe you're right - that you should let this visit happen, and then disengage yourself organically later. Because it doesn't sound like you're going to be able to deal with the repercussions of telling him to stay home.

Unless you're able to pull some grand scheme off, like giving him a vacation somewhere far away from you as a "Congratulations" for his new life direction and claiming that making the arrangements were why you were so ambiguous about saying he could come, I think you're painted into a mental corner with not enough time or ability to get out of it before vacation time.posted by Addlepated at 6:05 PM on October 30, 2010

You seem admirably self-aware, so you basically have me convinced you have to say Yes to get through the next few weeks. I really feel for you, and if now isn't a time when you have the energy or time or support system to go through the crisis that you know would occur (on your own end), that's a completely respectable decision.

But since you're asking and seem to want to find a way to say No, I agree with the direction that ImproviseOrDie and noella are pointing in. noella: "your own feelings deserve equal respect"

You: "I'm in the middle of a bunch of stressful changes in my own family life and a relatively tough school year"

In fact, I'm mad at your friend if I think of you there, barely making it through a stressful family situation and finals, and meanwhile he's holding this threat over your head. Maybe he can't help it, but still, then it makes me want to be like a teacher or parent standing between you two, telling him gently that you can't help him with his work now because you have to do your own homework first.

I wonder if you were to dwell on how precarious your own mental health sounds here and think about what it takes to protect your ability to function now and next semester, whether a new sense of urgency and self-protctiveness would grow. Could you tell him, as a friend, what you need and that you need his help now? Do you even really have a choice here? Is it maybe actually impossible to give him what he is asking without really hurting yourself? (It reminds me of the "put on your own oxygen mask first" announcement.)

You know what is best for yourself, though, and so again, if now isn't a time when you can take on his reaction and your reaction to that, you can't, and that's fine too. Best of luck now during finals and beyond.posted by salvia at 7:27 PM on October 30, 2010

I hear what you are saying, OP. You want to start limiting your friend's dependence on you, without triggering drama on his part. There is a time factor involved, which makes it more complicated.

When talking to him, don't take all the blame on yourself. That is where I guess the dynamic of your relationship is right now. Try to put some of the responsibility on him, where it belongs.

I do think limiting the visit is a good way to go about it, or suggesting a different time to visit.

What about asking him to come out and help you move? That takes the focus off him, and might actually help him feel useful to you, not just the other way around. It might jar him enough to actually see your feelings in this situation, as most depressed people are very self-focused. It also might help change the dynamics of your relationship in a good way.posted by annsunny at 7:27 PM on October 30, 2010

Tl;dr? I wonder if anger is the escape route you are looking for. (When someone threatens me, I feel angry.) If angry doesn't work, you might also try feeling deeply worried on your own behalf. (When I'm really worried about my own health, I retreat and take care of myself first.)posted by salvia at 7:41 PM on October 30, 2010

Even if, statistically, the chance of a successful suicide attempt is relatively small, I'm the main outside variable that affects his survival

You do not know this. You don't understand the psychology of borderline personality disorder (if that's something he has) well enough to say this. This is your anxiety talking.

Get into therapy ASAP. Even if you don't think it will help, you need someone to help you cope with the ongoing situation. By "ASAP" I mean tomorrow.

Xanax SUCKS. It's the shittiest of the benzos in my opinion. Benzos in general aren't great if you need to be clear-headed but Xanax, especially, is a peak/valley thing that makes you want more Xanax and it's a bad road to go down. I would avoid it as much as possible.

Your ADHD meds might be pushing your anxiety--if you're on stimulants I know how awesome they are but think about reducing or switching. I recently went from Vyvanse to Adderall and the difference in anxiety is amazing (ILU Adderall!)

This is not advice but just a thought--As someone who used to be prone to this kind of manipulative behavior (on a much smaller scale, but still) people tended to feel a lot guiltier and more responsible for me than they really needed to. It hurt, yes, but that hurt was about ME and not about them. It also helped to have people tell me no. Reinforcing this behavior can't help him in the long term, can it? I don't know.posted by the young rope-rider at 8:23 PM on October 30, 2010 [1 favorite]

It sounds like the time your friend wants to spend visiting you would be better spent checking himself into in-patient mental health treatment. It's like he's asking you to put a bandaid on his broken leg. You are not qualified to provide him the help he needs, and allowing him to lean on you for support like this seems to be delaying him seeking the help he needs.

If he is as suicidal and troubled as you say, then he has a serious life-threatening condition that needs treatment and I would ethically feel OK with calling his family or local police department to intervene with an involuntary commitment.posted by Jacqueline at 8:38 PM on October 30, 2010 [4 favorites]

Regarding your question about whether Xanax would be the same experience as another benzo, I have tried Xanax and found that Klonopin is better for me. It halts the anxiety faster and doesn't give me a headache like Xanax did.posted by IndigoRain at 11:03 PM on October 30, 2010

Can you frame this as your needing help from him?

As in "I do want to see you and I know that later will be less convenient for you. But I'm going through a seriously tough time right now with family and school and I'm having trouble handling just this much. I need you, my friend, to help me and support me [either by coming for a shorter visit or letting you visit him later or putting the whole thing off]."

This way his not visiting you would be about making the friendship stronger rather than weaker.

For what it's worth, don't be embarrassed about being seen with him. When I see someone supporting a person with obvious issues, I tend to admire them for doing it rather than projecting my opinion of the person they're with on them.posted by trig at 4:40 AM on October 31, 2010

trig has a good point, though I would leave off the asking for help part. Were I in your shoes I would frame it as explaining that I cannot be a good caretaker right now due to mental and physical health reasons, and that I am in the process of getting medical attention for them.

If framing it as asking for help, they might say, "oh I should come visit so that I can help you". Maybe the person would mean it genuinely but not have the self-insight to realize that they are not equipped to help right now.

Having been in a similar situation once, I did not follow my above advice and it was a disaster.

Is there any reason you have to decide today? Every day you can decide whether you are equipped to decide that day. If you can wait until you talk to a therapist about it, you will be better equipped to make the decision. If you cannot wait, and it is a mistake, have the frame that "you did the best you could with what you had at the time" and forgive yourself.posted by bleary at 7:27 AM on October 31, 2010

With respect to the suicide threat, at some point you have to trust that a person is equipped to deal with suicidal ideation because they have had doctors and therapists who have taught them how handle those thoughts. At some point it is out of your control and you have to trust to fate. (I don't know where the point lies, I just know I reached it once)posted by bleary at 7:33 AM on October 31, 2010

From the OP:

annsunny: Oh, he'd be thrilled if I asked him to come and help move. In fact, one of the complications here is that my family is trying to sell our house, so there's some small chance we may be already be moving by the time of his visit (seriously, how did you guess?); when I told him that, he told me that he'd come up just to help move if he had to. I mean, he'd much prefer an activity-filled vacation, of course, but that's how committed he is.

Jacqueline: Well, he's actually as good as he's been in years right now, but it appears that not getting this visit could easily set things up to go sour again. Yes, he still has very serious problems if something so small can put him over again, but that doesn't mean that I can necessarily deal with that happening right now. For what it's worth, he's been committed briefly in the past, and I've had to call the cops on him, but in his state the laws are such that the cops can't do anything unless they have evidence that he's an immediate danger to himself or others, or he goes voluntarily.

Oh, and about ColdChef's comment from the beginning of the thread--understand that his quality as a friend doesn't play into this for me, at all. Wouldn't matter if he were an enemy. My sense of responsibility here doesn't derive from loyalty to a friend, but a sense of moral responsibility for someone's life (whether or not I really should feel that in this situation).

jon1270: I'm asking, basically, "what should I do? Or, more reasonably, what are some ideas you guys can give me about how to think about what to do?"

I realize how hard it is to answer this question, because you guys don't really know much of the key information required, like my psychological trappings, what it might take to emotionally remove myself from the situation if he does take it as badly as he says, the nuances of his personality and how he might respond to various approaches, etc. So I'm really happy about the way you guys have managed to navigate the issue and offer meaningful suggestions anyway. I'm especially happy about the answers from people who appreciate that, even though it may go against common sense and basic intuition about what's fair or healthy, there is a depressingly strong case for just letting him come, and that deciding this is a legitimate dilemma.

Thanks again to everyone who's responded (so far). You've given me a wealth of input that will help me process this problem to some sort of logical conclusion--and even if that conclusion is wrong, I know now for sure that I'm not crazy for going either way, and I'll be able to forgive myself.

You've said you want to disentangle from this relationship "gradually and responsibly", but that may not be possible.

You've observed that he behaves like a person with BPD. Let's go with the idea that this is an accurate diagnosis. The problem with BPD is that one way it's experienced is as a black hole of need. He literally needs more than you can reasonably give -- that's how he determines whether you care, whether you really, really care, is whether you will sacrifice unreasonably for him. The more you demonstrate you care, the more demands he will place on the friendship.

The consequence is that the more you try to boundary and manage the friendship, the more he's going to pull and demand. You may have to face the possibility that "gradual" is not a reality.posted by endless_forms at 11:02 AM on October 31, 2010

While agreeing to a shorter visit is just kicking the can down the road in a lot of ways, maybe you can see it as a first step in the process of starting to stand up for your boundaries and well-being, the beginning of separating yourself from his life and your sense of responsibility for his life. Not that it's your responsibility either way, but if he is really in a mental state where seeing you for a few days versus two weeks is going to be the difference between him being suicidal or not, then I think that's a strong sign that it's going to be impossible for you ever to disengage "gradually or responsibly." Can you find the strength and self-preservation to offer to see him for a few days and then stick to that, knowing that you've offered more than should be expected of you and anything that he does as a result of that is not your responsibility? (If you can't, you can't... then, fine, put off the anxiety of the process until you're working with your own therapist. But I'd encourage you to do some soul-searching and really try see if you can get to a place where you can offer the shorter visit and stick to it with minimal anxiety. You may feel a lot better if you feel like you're starting to make progress with disentangling from this guy, rather than giving in and continuing to have this general anxiety hanging over your head about how you're ever going to make the break with him, in exchange for trying to avoid short-term acute anxiety about him being suicidal.)posted by EmilyClimbs at 3:09 PM on October 31, 2010

So to parahrase the obvious, your problem is not your friend's reaction to your "no", but your reaction to your friend's reaction.
I have no experience with anxiety but I think you should consider the following:
1) You need a pro to help you with that
2) awful things become less scary if you accept that they will be awful. So stop looking for a solution that won't lead to anxiety and stress. Accept that anxiety will happen and it will be awful, but that you will survive because you will have professional help. Accept it as the price you pay for the freedom you will gain. And boy, it will feel good.
3) can you afford to have your life disrupted for this right now? If absolutely not, you will have to delay the plan. But you sound on the brink of not taking it anymore, and I think the time is right.
4) with people like that there is no slow, gentle way of getting rid of them. There never will be. You mean too much for your friend to just drift out of his life slowly. The more you seek distance, the more he'll crank up his effort. I speak from experience.
5) if he threatens suicide, call 911 on him. This might bring home the reality to your friend and might help with your need to do something.posted by Omnomnom at 4:29 PM on October 31, 2010

I should add
6) accept that he will never understand your "cruelty" and in the narrative of his own life you will thereafter be the person who abandoned him to suicide. Accept that you can not make him understand. Accept that you will be the bad guy in his life story, the one person he counted on who let him down.
You cannot dictate how he sees you. part of your health is accepting that sometimes, for some people, you will be the bad guy.posted by Omnomnom at 4:39 PM on October 31, 2010

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